Articles

Curing (Compassion) Fatigue

I wake up early in the morning, and small choices immediately start coming my way. Outfits for my three children, what to make for breakfast, should I pack a cookie in their lunch? Then, I head to work, and I am bombarded by a steady tidal wave of patients. What’s my differential, what tests do I order, what treatments do I choose? Decision, after decision, after decision, all day long. I get home, and it’s no surprise that, when my kids ask what’s for dinner, my eyes roll up into my head, and I start talking gibberish.

Decision fatigue is annoying, but what is even worse is compassion fatigue. Working in the ER, we hear people’s stories. Oh, you had a hard time getting your mom to the ER for the third time this week because your kid was sick? I got nuthin. You feel like garbage because you drank too much last night? Ha ha ha! You’re homeless and here because you wanted a warm place to stay? Get outta here!

Have you heard those thoughts running through your head? I know that this is not just a problem for ER folks. PAs get bombarded by patients with difficult social situations, complicated diagnoses and tragically sad losses. May I suggest that we healthcare providers need a mental health reboot?

I don’t work in psych, but I believe taking care of people for a career can encourage the development of some unhealthy practices. We see sadness, and yet, we don’t feel sad. We watch suffering, and move on to the next patient. We hear about abuse or neglect, call the social worker and shrug our shoulders. I think this comes from years of denying ourselves emotions while in the workplace.

“May I suggest that we healthcare providers need a mental health reboot?”

This is not the way to career satisfaction, to say the least. Wake up, people! This is eating away at us from the inside out. We need more connection, not disengagement. This is an epidemic, and we keep pushing it under the rug. There needs to be more space in our workplace and at home to express emotions and acknowledge losses.

I know. This seems really “soft.” We don’t like being “soft” in medicine. We plow through, get our quotas up, don’t let anyone know our weaknesses. This is not sustainable! To leave our emotions at the door is not human, and trying to stuff things without an outlet creates negative outcomes.

Anxiety, PTSD, depression, irritability. I believe these are some side effects of our current model. What would it look like if, after a particularly difficult patient, we were able to sit, take a deep breath and acknowledge that we are affected deeply—because we’re human. Then, taking it even further: What if we shared that emotion with a trusted coworker? Acknowledging and sharing emotions has a lot of healing power. Having someone else to agree and support you, just by saying, “me too,” is powerful! Stuffing or denying the emotion is powerful as well. It can fester and come out sideways, especially with people we love the most.

I know I lost some of you at the word “emotion.” My hope is that we can continue to push for healthy work environments together. Be brave with me and take a moment today to be vulnerable. Compassion fatigue is curable, but it is an active process that can be uncomfortable. I think in the long run, it’s worth it!

Rachael Jarman, PA-C, works in the ER of a busy Minneapolis hospital and as a pre-PA admissions coach, and occasionally, as a guest lecturer for PA programs in Minnesota. She is a graduate of Philadelphia University’s PA program.